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Chiang-Wen Lee,1– 4,* Thi Thuy Tien Vo,5,* Yinshen Wee,6 Yao-Chang Chiang,1,2 Miao-Ching Chi,7– 9 Min-Li Chen,10,11 Lee-Fen Hsu,9,12 Mei-Ling Fang,13,14 Kuan-Han Lee,15 Su-Er Guo,11 Hsin-Chung Cheng,5,16 I-Ta Lee5 1Department of Nursing, Division of Basic Medical Sciences, Chronic Diseases and Health Promotion Research Center and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan; 2Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan; 3Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan; 4College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 5School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; 6Department of Pathology, University of Utah, Salt Lake City, UT, USA; 7Chronic Disease and Health Promotion Research Center, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan; 8Division of Pulmonary and Critical Care Medicine, Chiayi Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan; 9Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan; 10Department of Nursing, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan; 11Graduate Institute of Nursing, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan; 12Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan; 13Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan; 14Super Micro Research and Technology Center, Cheng Shiu University, Kaohsiung, Taiwan; 15Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 16Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan*These authors contributed equally to this workCorrespondence: I-Ta LeeSchool of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, TaiwanTel +886-2-27361661 ext. 5162Fax +886-2-27362295Email itlee0128@tmu.edu.twAbstract: Incense burning is a very popular activity in daily life among many parts all over the world. A growing body of both epidemiological and experimental evidences has reported the negative effects of incense use on human well-being, posing a potential threat at public significance. This work is a comprehensive review that covers the latest findings regarding the adverse impact of incense smoke on our health, providing a panoramic visualization ranging from mechanisms to implications. The toxicities of incense smoke come directly from its harmful constituents and deposition capacity in the body. Besides, reactive oxygen species-driven oxidative stress and associated inflammation seem to be plausible underlying mechanisms, eliciting various unfavorable responses. Although our current knowledge remains many gaps, this issue still has some important implications.Keywords: incense burning, oxidative stress, inflammation, cancer, toxicants

Abstract To evaluate the response and quality of life of palliative gastric radiotherapy in patients with symptomatic locally advanced gastric cancer. Patients with bleeding, pain or obstruction and were treated with palliative gastric radiotherapy to a dose of 36 Gy in 12 daily fractions. The primary outcomes were symptom response rates. Secondary outcomes included overall survival, adverse events and proportion of patients with ≥10‐point absolute improvement in the fatigue, nausea/vomiting and pain subscales in the EORTC Qualify of Life Questionnaire C30 (EORTC QLQ‐C30) and dysphagia/pain subscales in the gastric specific module (STO22) at the end of RT and 1 month after the completion of radiotherapy. Fifty patients were accrued. Median survival duration was 85 days. 40/50 patients (80%) with bleeding, 2/2 (100%) patients with obstruction and 1/1 (100%) patient with pain responded to radiotherapy. Improvements fatigue, nausea/vomiting and pain subscales of the EORTC QLQ‐C30 was seen in 50%, 28% and 44% of patients at the end of RT and in 63%, 31% and 50% of patients 1 month after RT. Improvements in dysphagia/pain subscales of the STO22 was seen in 42% and 28% of patients at then end of RT and 44% and 19% of patients 1 month after RT. Two patients (5%) had grade 3 anorexia and gastritis. Palliative gastric radiotherapy was effective, well tolerated and resulted in improvement in fatigue, dysphagia and pain at the end of radiotherapy and 1 month after the completion of radiotherapy in a significant proportion of patients.

Nanoparticle incorporation plays an active feature in heat transfer, ultimately enhancing the tribological process under boundary conditions of heat stress. Nanoparticles like zinc oxide (ZnO) and multiwall carbon nanotubes (MWCNT) are well known to significantly affect the cooling and lubrication applications, resulting in improved heat transfer and kinematic viscosity. The present work investigates the tribological performance of ZnO/MWCNTs hybrids as lubricant additive in the paraffinic type of mineral base oil of Group I (SN150) engine oil. The chemical composition of the modified and unmodified oil was examined by an inductively coupled plasma-optical emission spectrometer (ICP-OES), energy dispersive x-ray fluorescence (EDXRF) spectrometer, and Fourier-transform infrared spectroscopy (FTIR). A ring-ondisk tribotester was performed to investigate the tribological behaviour through the linear reciprocating mechanism alloy-steel contacts. The worn steel alloy surfaces morphology and chemical compositions were examined by scanning electron microscope (SEM), energy-dispersive x-ray spectroscopy (EDX), and 3D optical profilometer. Different ZnO/MWCNTs nanomaterial volumetric concentrations were examined in order to determine the most effective performance. According to the tribological results, ZnO/MWCNTs hybrid nanomaterials in the engine oil were found to have significantly higher friction temperature and antiwear capability than the base oil. A volumetric concentration of 3.00 wt% ZnO/MWCNTs nanomaterials to SN150 engine oil imparted excellent wear protection to the steel sample than the pure SN150 base oil. Based on the statistical analysis, the modified oil anti-wear performance was enhanced by reducing the wear loss by 80.5% and friction temperature by 55.8°C compared with the oil base. [ABSTRACT FROM AUTHOR]

Abstract Purpose Accurate prognostication may aid in the selection of patients who will benefit from surgery at recurrent WHO grade 4 glioma. This study aimed to evaluate the role of serial tumour volumetric measurements for prognostication at first tumour recurrence. Methods We retrospectively analyzed patients with histologically-diagnosed WHO grade 4 glioma at initial and at first tumour recurrence at a tertiary hospital between May 2000 and September 2018. We performed auto-segmentation using ITK-SNAP software, followed by manual adjustment to measure serial contrast-enhanced T1W (CE-T1W) and T2W lesional volume changes on all MRI images performed between initial resection and repeat surgery. Results Thirty patients met inclusion criteria; the median overall survival using Kaplan-Meier analysis from second surgery was 10.5 months. Seventeen (56.7%) patients received treatment post second surgery. Univariate cox regression analysis showed that greater rate of increase in lesional volume on CE-T1W (HR = 2.57; 95% CI [1.18, 5.57]; p = 0.02) in the last 2 MRI scans leading up to the second surgery was associated with a higher mortality likelihood. Patients with higher Karnofsky Performance Score (KPS) (HR = 0.97; 95% CI [0.95, 0.99]; p = 0.01) and who received further treatment following second surgery (HR = 0.43; 95% CI [0.19, 0.98]; p = 0.04) were shown to have a better survival. Conclusion Higher rate of CE-T1W lesional growth on the last 2 MRI images prior to surgery at recurrence was associated with increase mortality risk. A larger prospective study is required to determine and validate the threshold to distinguish rapidly progressive tumour with poor prognosis.

Background Patients with advanced non-small-cell lung cancer (NSCLC) with activating mutations in the epidermal growth factor receptor (EGFR) gene are a heterogeneous population who often develop brain metastases (BM). The optimal management of patients with asymptomatic brain metastases is unclear given the activity of newer-generation targeted therapies in the central nervous system. We present a protocol for an individual patient data (IPD) prospective meta-analysis to evaluate whether the addition of stereotactic radiosurgery (SRS) before osimertinib treatment will lead to better control of intracranial metastatic disease. This is a clinically relevant question that will inform practice.Methods Randomised controlled trials will be eligible if they include participants with BM arising from EGFR-mutant NSCLC and suitable to receive osimertinib both in the first-line and second-line settings (P); comparisons of SRS followed by osimertinib versus osimertinib alone (I, C) and intracranial disease control included as an endpoint (O). Systematic searches of Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), PsychInfo, ClinicalTrials.gov and the WHO’s International Clinical Trials Registry Platform’s Search Portal will be undertaken. An IPD meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome is intracranial progression-free survival, as determined by response assessment in neuro-oncology-BM criteria. Secondary outcomes include overall survival, time to whole brain radiotherapy, quality of life, and adverse events of special interest. Effect differences will be explored among prespecified subgroups.Ethics and dissemination Approved by each trial’s ethics committee. Results will be relevant to clinicians, researchers, policymakers and patients, and will be disseminated via publications, presentations and media releases.Prospero registration CRD42022330532.

This study examines the socioeconomic impact of the COVID-19 pandemic and the sufficiency of government support. Based on an online survey with 920 respondents, the cross-tabulation and binary logistic regression results show: firstly, in terms of loss of income, male respondents are more likely to have a loss of income as compared to female counterparts, and secondly, among different categories of employment status, the self-employed respondents are the most vulnerable group, given that more than 20 percent of them experienced loss of income due to the COVID-19 pandemic. Moreover, respondents working in small-and-medium enterprises (SMEs) and the informal sector are more likely to face loss of income as compared to respondents working in other sectors of employment. Likewise, respondents without tertiary education level are more likely to have a loss of income as compared to respondents with university certification. The baseline results highlight the insufficiency of government financial support programs based on the perspective of Malaysians from different demographic backgrounds. As a policy implication, the findings could guide the State in formulating the right policies for target groups who need more assistance than others in the community.

The world's health, economic, and social systems have been adversely impacted by the COVID-19 pandemic. With lockdown measures being a common response strategy in most countries, many individuals were faced with financial and mental health challenges. The current study explored the effect of the COVID-19 pandemic on the psychological well-being, perception of risk factors and coping strategies of two vulnerable groups in Malaysia, namely women and older adults from low-income households (USD592). A purposive sample of 30 women and 30 older adults was interviewed via telephone during Malaysia's Movement Control Order (MCO) regarding the challenges they faced throughout the pandemic. Thematic analysis was subsequently conducted to identify key themes. The themes identified from the thematic analysis indicated a degree of overlap between both groups. For women, seven themes emerged: 1) Psychological challenges due to COVID-19 pandemic, 2) Family violence, 3) Finance and employment related stress and anxiety, 4) Women's inequality and prejudice, 5) Coping strategies, 6) Professional support, and 7) Women's empowerment. Similarly, there were six themes for the older adults: 1) Adverse emotional experiences from COVID-19, 2) Threats to health security, 3) Loss of social connections, 4) Government aid to improve older adults' psychological well-being, 5) Psychological support from family members and pets, and 6) Self-reliance, religion, and spirituality. The findings provide valuable information on the specific burdens faced by these groups, and support psychological interventions and mitigations that would be appropriate to improve well-being during the recovery phase.

Fermentation of pumpkin puree and mature coconut water using water kefir grains is a potential method for producing a novel functional non-dairy-based probiotic drink. In the present study, response surface methodology based on Box–Behnken design (RSM-BBD) was used to optimise fermentation temperature and substrates’ concentrations. The optimised fermentation temperature, pumpkin puree, and brown sugar concentrations of pumpkin-based mature coconut water kefir beverage (PWKC) were 27 °C, 20%, and 10% w/v, respectively. The optimised PWKC (PWKCopt) obtained an overall acceptability (OA) score of 4.03, with a desirable Lactobacillus count (6.41 Log CFU/mL), 0.68% v/v lactic acid content, 31% of water kefir grains’ biomass growth rate, and fermentation time (to reach pH 4.5) of 4.5 h. The optimized beverage, PWKCopt, contained 3.26% proteins, 2.75% dietary fibre, 2186.33 mg/L of potassium, 180.67 mg/L phosphorus, and 137.33 mg/L calcium and had a total phenolic content of 89.93 mg GAE/100 mL, flavonoid content of 49.94 mg QE/100 mL, and carotenoid content of 33.24 mg/100 mL, with antioxidant activity (FRAP: 169.17 mM Fe(II)/100 mL, IC50 value of DPPH free radicals scavenging activity: 27.17 mg/mL). Water kefir microorganisms in PWKCopt remained stable for at least 56 days at 4 °C. Therefore, PWKCopt might potentially serve as a value-added product, offering a basis for sustainable development within both the coconut and pumpkin industries.

BackgroundLyme disease is among the most reported tick-borne diseases worldwide, making it a major ongoing public health concern. An effective Lyme disease case reporting system depends on timely diagnosis and reporting by health care professionals, and accurate laboratory testing and interpretation for clinical diagnosis validation. A lack of these can lead to delayed diagnosis and treatment, which can exacerbate the severity of Lyme disease symptoms. Therefore, there is a need to improve the monitoring of Lyme disease by using other data sources, such as web-based data. ObjectiveWe analyzed global Twitter data to understand its potential and limitations as a tool for Lyme disease surveillance. We propose a transformer-based classification system to identify potential Lyme disease cases using self-reported tweets. MethodsOur initial sample included 20,000 tweets collected worldwide from a database of over 1.3 million Lyme disease tweets. After preprocessing and geolocating tweets, tweets in a subset of the initial sample were manually labeled as potential Lyme disease cases or non-Lyme disease cases using carefully selected keywords. Emojis were converted to sentiment words, which were then replaced in the tweets. This labeled tweet set was used for the training, validation, and performance testing of DistilBERT (distilled version of BERT [Bidirectional Encoder Representations from Transformers]), ALBERT (A Lite BERT), and BERTweet (BERT for English Tweets) classifiers. ResultsThe empirical results showed that BERTweet was the best classifier among all evaluated models (average F1-score of 89.3%, classification accuracy of 90.0%, and precision of 97.1%). However, for recall, term frequency-inverse document frequency and k-nearest neighbors performed better (93.2% and 82.6%, respectively). On using emojis to enrich the tweet embeddings, BERTweet had an increased recall (8% increase), DistilBERT had an increased F1-score of 93.8% (4% increase) and classification accuracy of 94.1% (4% increase), and ALBERT had an increased F1-score of 93.1% (5% increase) and classification accuracy of 93.9% (5% increase). The general awareness of Lyme disease was high in the United States, the United Kingdom, Australia, and Canada, with self-reported potential cases of Lyme disease from these countries accounting for around 50% (9939/20,000) of the collected English-language tweets, whereas Lyme disease–related tweets were rare in countries from Africa and Asia. The most reported Lyme disease–related symptoms in the data were rash, fatigue, fever, and arthritis, while symptoms, such as lymphadenopathy, palpitations, swollen lymph nodes, neck stiffness, and arrythmia, were uncommon, in accordance with Lyme disease symptom frequency. ConclusionsThe study highlights the robustness of BERTweet and DistilBERT as classifiers for potential cases of Lyme disease from self-reported data. The results demonstrated that emojis are effective for enrichment, thereby improving the accuracy of tweet embeddings and the performance of classifiers. Specifically, emojis reflecting sadness, empathy, and encouragement can reduce false negatives.

This study aimed to produce acetone‐butanol‐ethanol (ABE) using lignocellulosic crop residues as renewable bioresources. Butanol production from banana crop residue (BCR) was studied using a newly isolated solventogenic Clostridium beijerinckii YVU1. BCR is one of the abundant lignocellulosic substrates available in tropical countries containing 4·3 ± 3·5% cellulose, 28·5 ± 3·0% hemicellulose and 20·3 ± 2·6% lignin. The sequential dilute alkali and acid pretreatments solubilized 69% of lignin and 73% of hemicellulose. Ten percent (w/v) of pretreated substrate was subjected to enzymatic saccharification with cellulase, and it was found to release 0·481 ± 0·035 g glucose per g pretreated biomass. In the batch fermentation process, 20·5 g l−1 ABE (14·0 g l−1 of butanol, 5·4 g l−1 of acetone and 1·1 g l−1 of ethanol) was obtained. The executed fermentation process yielded 0·39 g ABE per g hydrolysate with 0·14 g l−1 h−1 of volumetric productivity. On the basis of the results, we believe that sequential alkali and acid pretreatment on the enzymatic hydrolysis for butanol production is indeed a technology with the potential to be applied and newly isolated. C. beijerinckii YVU1 is also a potential candidate organism for butanol production agricultural residues. Significance and Impact of the Study: This study demonstrates that a banana crop residue (BCR) can be successfully utilized as an inexpensive and alternative bioresource for the production of acetone‐butanol‐ethanol (ABE). The sequential pretreatment of BCR with alkali and acid solubilized lignin and hemicellulose leading to high glucose release during enzymatic hydrolysis. A newly isolated Clostridium beijerinckii YVU1 was able to produce comparable amount of ABE with previous reports. Therefore, we can state that the utilization of BCR as substrate for C. beijerinckii YVU1 leads to an economical bioprocess for the microbial production of ABE. [ABSTRACT FROM AUTHOR]

PurposeWe report the ocular findings that patients experienced after receiving the coronavirus disease 2019 (COVID-19) vaccination in three different eye centers in Malaysia.ObservationsA total of four cases were reported. Three patients received the Pfizer-BioNTech vaccine, while the other received the Oxford AstraZeneca type. Ocular symptoms occurred after the first vaccine dose in two patients and after the second vaccine dose in the other two. Three out of four patients required active treatment for their vision complications postvaccination. The first patient had acute-onset retinal pigment epitheliitis within 3 h of vaccination and was treated conservatively. The second patient developed unilateral choroidal neovascularization 3 days after vaccination and required intravitreal antivascular endothelial growth factor injection. The third patient presented with bilateral acute multifocal placoid pigment epitheliopathy a week after vaccination and responded to intravenous methylprednisolone. The fourth patient presented with herpes zoster infection and unilateral anterior nongranulomatous uveitis 2 weeks after vaccination and was treated with oral acyclovir and topical corticosteroids. All patients reported some amount of visual recovery.Conclusions and importanceVisual symptoms and various ocular adverse events can occur following COVID-19 vaccination, which warrants further investigation and urgent intervention if necessary. We would suggest patients receiving the COVID-19 vaccination be aware of possible ocular complications and report any symptoms, regardless of severity.

The Retirement Fund Incorporated (KWAP) manages the civil servant pension fund. It is a statutory body governed by the Ministry of Finance to manage Malaysia’s civil employees’ pension scheme. In order to examine the fund’s long-term sustainability, this study simulates 560 scenarios to examine the required rate of return needed to fund this defined benefit pension based on four parameters, namely contribution rate, years of service, retirement age and life expectancy. Our results show: First, the minimum years of service for pension eligibility should be increased to 20 years. Second, a contribution rate of at least 13 percent per worker to KWAP is needed. Third, there are no significant changes in the required rate of return even though the retirement age is extended from 55 to 60. Fourth, this study shows that the contribution period is more crucial than the post-retirement period for the sustainability of the pension fund. As a policy suggestion, there is a need for the authority to set a minimum funding ratio for the KWAP pension fund to ensure its long-term sustainability.

Summary: Genomic researchers increasingly utilize commercial cloud service providers (CSPs) to manage data and analytics needs. CSPs allow researchers to grow Information Technology (IT) infrastructure on demand to overcome bottlenecks when combining large datasets. However, without adequate security controls, the risk of unauthorized access may be higher for data stored on the cloud. Additionally, regulators are mandating data access patterns and specific security protocols for the storage and use of genomic data. While CSP provides tools for security and regulatory compliance, building the necessary controls required for cloud solutions is not trivial. Research Assets Provisioning and Tracking Online Repository (RAPTOR) by the Genome Institute of Singapore is a cloud-native genomics data repository and analytics platform that implements a “five-safes” framework to provide security and governance controls to data contributors and users, leveraging CSP for sharing and analysis of genomic datasets without the risk of security breaches or running afoul of regulations.

Abstract Background Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efficacy trials of the COVID-19 vaccine. Case presentation We report the first case of Longitudinal Extensive Transverse Myelitis (LETM) in Malaysia following administration of the chimpanzee adenovirus-vectored (ChAdOx1 nCoV-19) vaccine. A 25-year-old female presented with bilateral lower limb weakness and inability to walk with a sensory level up to T8 with absent visual symptoms. Urgent gadolinium-enhanced magnetic resonance imaging (MRI) of the spine showed long segment TM over the thoracic region. Cerebrospinal fluid autoantibodies for anti-aquaporin-4 and anti-myelin-oligodendrocyte were negative. A diagnosis of LETM following vaccination was made, and the patient was started on a high dose of intravenous methylprednisolone. The patient eventually made a recovery following treatment. Conclusion LETM is a rare but serious adverse reaction following vaccination. Previously reported cases showed an onset of symptoms between 10 to 14 days post-vaccination, suggesting a delayed immunogenic reaction. However, the incidence of myelitis in COVID-19 is much more common, far greater than the risk associated with vaccination.

Urea is naturally present in milk, yet urea is added intentionally to increase milk’s nitrogen content and shelf life. In this study, a total of 50 Ultra heat treatment (UHT) milk samples were spiked with known urea concentrations (0–5 w/v%). Attenuated total reflectance–Fourier transform infrared (ATR-FTIR) spectroscopy with principal component analysis (PCA), discriminant analysis (DA), and multiple linear regression (MLR) were used for the discrimination and quantification of urea. The PCA was built using 387 variables with higher FL > 0.75 from the first PCA with cumulative variability (90.036%). Subsequently, the DA model was built using the same variables from PCA and demonstrated the good distinction between unadulterated and adulterated milk, with a correct classification rate of 98% for cross-validation. The MLR model used 48 variables with p-value < 0.05 from the DA model and gave R2 values greater than 0.90, with RMSE and MSE below 1 for cross-validation and prediction. The DA and MLR models were then validated externally using a test dataset, which shows 100% correct classification, and the t-test result (p > 0.05) indicated that the MLR could determine the percentage of urea in UHT milk within the permission limit (70 mg/mL). In short, the wavenumbers 1626.63, 1601.98, and 1585.5534 cm−1 are suitable as fingerprint regions for detecting urea in UHT milk.

Xuling Chang et al. study whether low frequency variants are associated with leukocyte telomere length and whether these variants predispose to incident cancers and mortalities among East Asians. They find that three East Asian specific variants at POT1, TERF1 and STN1 loci are associated with leukocyte telomere length and report a mechanistic pathway linking TERF1, leukocyte telomere length and incident colon cancer.

The increasing prevalence of gluten-related disorders has led to higher consumer demand for convenient, gluten-free bakery products with health-promoting properties. In this study, non-gluten shortbread cookies were incorporated with various kinds of spent (green, oolong, and black) tea leaves powder (STLP) at 8% w/w. Cookies with STLP had significantly higher (p < 0.05) moisture (2.18–2.35%), crude fibre (14.5–14.9%), total dietary fibre (22.38–22.59%), insoluble dietary fibre (15.32–15.83%), soluble dietary fibre (7.06–7.66%), and ash (1.9–2.0%) contents, but were significantly lower (p < 0.05) in carbohydrate (53.2–53.9%) and energy value (426.4–428.2 kcal) compared to control cookies (1.62%; 1.43%; 6.82%; 4.15%; 2.67%; 7.70%; 62.2%; and 457.8 kcal, respectively). The addition of STLP significantly enhanced (p < 0.05) the antioxidant properties of the cookies. Non-gluten shortbread cookies with spent green tea leaves powder (GTC) received the highest (p < 0.05) score for all sensory attributes, including overall acceptability. In addition, the shelf-life quality of the formulated cookie samples in terms of the moisture content, water activity, colour, texture, microbiology, and sensory properties was maintained (p > 0.05) for at least 22 days at 25 °C. STLP, which would have been previously thrown away, could be utilized as a potential functional ingredient to produce non-gluten shortbread cookies with enhanced nutritional, physicochemical, microbiological, sensory, and antioxidative properties.

To date, surgical interventions are the only means by which craniofacial anomalies can be corrected so that function, esthetics, and the sense of well-being are restored in affected individuals. Unfortunately, for patients with cleft palate-one of the most common of congenital birth defects-treatment following surgery is prolonged over a lifetime and often involves multidisciplinary regimens. Hence, there is a need to understand the molecular pathways that control palatogenesis and to translate such information for the development of noninvasive therapies that can either prevent or correct cleft palates in humans. Here, we use the well-characterized model of the Pax9-/- mouse, which displays a consistent phenotype of a secondary cleft palate, to test a novel therapeutic. Specifically, we demonstrate that the controlled intravenous delivery of a novel mouse monoclonal antibody replacement therapy, which acts as an agonist for the ectodysplasin (Eda) pathway, can resolve cleft palate defects in Pax9-/- embryos in utero. Such pharmacological interventions did not reverse the arrest in tooth, thymus, and parathyroid gland development, suggesting that the relationship of Pax9 to the Eda/Edar pathway is both unique and essential for palatogenesis. Expression analyses and unbiased gene expression profiling studies offer a molecular explanation for the resolution of palatal defects, showing that Eda and Edar-related genes are expressed in normal palatal tissues and that the Eda/Edar signaling pathway is downstream of Pax9 in palatogenesis. Taken together, our data uncover a unique relationship between Pax9 and the Eda/Edar signaling pathway that can be further exploited for the development of noninvasive, safe, and effective therapies for the treatment of cleft palate conditions and other single-gene disorders affecting the craniofacial complex. [ABSTRACT FROM AUTHOR]

The world faces unprecedented challenges because of the Coronavirus Disease 2019 (COVID-19). Existing theories of human flourishing and coping efficacy are too broad and general to address COVID-19 unprecedented mental health challenges. This study examined two main objectives, first the associations between psychological outcomes (i.e., depression, anxiety, and stress) and psychological wellbeing of this phenomenon, and second, moderating and mediating factors emotions, resilience and coping self-efficacy. A nationwide survey was carried out on a Malaysian sample (n = 920). Participants completed an on-line survey that assessed psychological outcomes, psychological wellbeing, positive–negative emotions, resilience, and coping self-efficacy. The relationship between psychological states and psychological wellbeing was successfully mediated by coping self-efficacy (direct effects of −0.31 to −0.46 at p

Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Gamma-aminobutyric acid (GABA) has potential in regulating hypertension. Cocoa beans are rich in GABA, but GABA is being destroyed during roasting of cocoa beans and chocolate production. This study aimed to develop GABA-enriched dark chocolate by partially replacing sugar syrup with pure GABA powder at concentrations of 0.05 (F1), 0.10 (F2), and 0.15% (F3). The chocolate samples were incorporated with GABA after the heating and melting process of cocoa butter to maintain the viability and functionality of the GABA in the final product. The effects of GABA enrichment on the quality of chocolate in terms of nutritional, physical, shelf-life, and sensorial properties were studied. The inclusion of 0.15% GABA significantly increased the GABA content and angiotensin-converting-enzyme (ACE) inhibitory effect of chocolate. The nutritional compositions of the control and GABA-enriched chocolates were almost similar. The addition of GABA significantly increased the hardness but did not affect the apparent viscosity and melting properties of chocolate. Accelerated shelf-life test results showed that all the chocolates stored at 20 and 30 °C were microbiologically safe for consumption for at least 21 days. Among the GABA-enriched chocolates, panellists preferred F2 the most followed by F3 and F1, owing to the glossiness and sweetness of F2. F3 with the highest GABA content (21.09 mg/100 g) and ACE inhibitory effect (79.54%) was identified as the best GABA-enriched dark chocolate.

The growing health awareness among consumers has increased the demand for non-dairy-based products containing probiotics. However, the incorporation of probiotics in non-dairy matrices is challenging, and probiotics tend to have a low survival rate in these matrices and subsequently perform poorly in the gastrointestinal system. Encapsulation of probiotics with a physical barrier could preserve the survivability of probiotics and subsequently improve delivery efficiency to the host. This article aimed to review the effectiveness of encapsulation techniques (coacervation, extrusion, emulsion, spray-drying, freeze-drying, fluidized bed coating, spray chilling, layer-by-layer, and co-encapsulation) and biomaterials (carbohydrate-, fat-, and protein-based) on the viability of probiotics under the harsh conditions of food processing, storage, and along the gastrointestinal passage. Recent studies on probiotic encapsulations using non-dairy food matrices, such as fruits, fruit and vegetable juices, fermented rice beverages, tea, jelly-like desserts, bakery products, sauces, and gum products, were also included in this review. Overall, co-encapsulation of probiotics with prebiotics was found to be effective in preserving the viability of probiotics in non-dairy food matrices. Encapsulation techniques could add value and widen the application of probiotics in the non-dairy food market and future perspectives in this area.

Shortening of leukocyte telomere length (LTL) is associated with age and increased risk for various chronic diseases. Here, the authors report genome-wide association studies for LTL in Singaporean Chinese populations and find that longer LTL associates with less severe outcomes of respiratory disease phenotypes.

Instant noodles are consumed worldwide, but instant noodles are often unhealthy. Therefore, in the current study, instant noodles were produced with composite flour (a blend of wheat flour and potato starch at weight ratios of 9:1, 8:2, and 7:3) incorporated with red seaweed powder (Eucheuma denticulatum) in proportions of 0, 5, 7.5, 10, 12.5, and 15%. The noodles’ sensory, physicochemical, and cooking properties were then determined. The incorporation of 7.5–15% of seaweed powder significantly (p < 0.05) increased the cooking yield, reduced the cooking loss, lengthened the cooking time, and decreased the pH values and water activity. The addition of seaweed powder weakened the tensile strength and softened the noodles. Seaweed noodles were denser and greener than control noodles. Among the three seaweed noodles (F2, F5, and F12) selected through the ranking test, panelists preferred F2 and F5 (both scoring 4.63 on a 7-point hedonic scale for overall acceptability) more than F12. Overall, F5 (at a wheat flour: potato starch ratio of 9:1; 15% seaweed powder) is the best-formulated seaweed noodle in this study, owing to its highest cooking yield and lowest cooking loss even with prolonged cooking, lowest water activity, and acceptable sensory qualities.

Abstract Background The survival benefit of PCI in ES-SCLC reported by a European randomized trial (RCT) in 2007 was not replicated by a Japanese RCT published in 2017. This study aimed to evaluate the uptake of PCI before and after publication of the European RCT and its association with survival in ES-SCLC. Methods We identified eligible patients in the only two Singapore national cancer centres from 2003 to 2010. We linked their electronic medical records to the national death registry. We described the utilization of PCI in patients diagnosed from 2003 to 2006 (pre-adoption cohort) with patients diagnosed from 2007 to 2010 (post-adoption cohort). We performed univariable and multivariable Cox regression analysis to assess the association between PCI and survival. Results We identified 224 patients with ES-SCLC with no brain metastases. Among the 71 patients who had at least stable disease after first line chemotherapy, there was an increase in the use of PCI from the period 2007 to 2010 compared with 2003 to 2006 (32% versus 10%, P = 0.044). PCI was associated with improved OS (hazard ratio 0.22, 95% CI 0.10 to 0.47, P

Abstract Background Rottweilers are reportedly predisposed to many disorders but accurate prevalence information relating to the general population are lacking. This study aimed to describe demography, mortality and commonly recorded diseases in Rottweilers under UK veterinary care. Clinical health records within the VetCompass Programme were explored for disorders recorded during 2013. Results Rottweilers comprised 5321 (1.17%) of 455,557 dogs attending 304 clinics. Annual proportional birth rates dropped from 1.75% in 2006 to 1.07% in 2013. Median adult bodyweight overall was 44.9 kg (IQR 39.55–51.00, range 20.00–88.80). Median male adult bodyweight (48.5 kg, interquartile range [IQR] 43.0–54.0, range 20.0–88.8) was heavier than female (41.5 kg, IQR 37.0–46.4, range 21.1–73.5) (P < 0.001). Median longevity overall was 9.0 years (IQR 7.2–10.5, range 0.0–17.0). Median female longevity (9.5 years, IQR 7.8–11.0) was greater than male (8.7 years, IQR 6.8–10.1) (P = 0.002). The most common causes of death were neoplasia (33.0%), inability to stand (16.0%) and mass-associated disorder (7.1%). At least one disorder was recorded for 60.31% of Rottweilers. The most prevalent specific disorders recorded were aggression (7.46%, 95% CI 6.40–8.64), overweight/obesity (7.06%, 95% CI: 6.02–8.21), otitis externa (6.14%, 95% CI: 5.18–7.23) and degenerative joint disease (4.69%, 95% CI: 3.84–5.66). Male Rottweilers had higher prevalence than females for aggression (9.36% versus 5.47%, P = 0.001) and pyotraumatic dermatitis (4.05% versus 1.76%, P = 0.001). Aggression was more prevalent in neutered than entire females (7.5% versus 3.1%, P = 0.003) but did not differ between neutered and entire males (9.6% versus 9.0%, P = 0.773). The most frequent disorder groups were musculoskeletal (12.01%, 95% CI: 10.69–13.45), dermatological (10.96%, 95% CI: 9.69–12.35), gastro-intestinal (195, 8.87%, 95% CI: 7.72–10.14), undesirable behaviour (7.96%, 95% CI: 6.87–9.18) and neoplasia (7.96%, 95% CI: 6.87–9.18). Conclusions The current study assists prioritisation of health issues within Rottweilers. Rottweilers are relatively short-lived and neoplasia is a common cause of death. The most common disorders were aggression, overweight/obesity, otitis externa and degenerative joint disease. Males were significantly heavier, shorter-lived and predisposed to aggression than females. These results can alert prospective owners to potential health issues and optimise sex selection decision-making.

Cu-based shape memory alloys are used in various applications due to their attractive shape memory effect, easier process and cheaper cost. Cu-Al-Ni SMAs are one of the well-known Cu-based shape memory alloys because of their capability in demonstrating shape memory effect, damping behaviour, and thermoelastic martensitic transformation. In this paper, the effect of Ti addition on the phase transformation temperatures and microstructures of Cu-Al-Ni SMA was investigated. The Cu-Al-Ni alloy specimens were casted with the addition of titanium (Ti) using an induction furnace. Transformation temperature of the alloy was studied by differential scanning calorimetry. The evolution of the phases and microstructures was investigated by using the field emission scanning electron microscopy corresponding with energy dispersive spectroscopy and X-ray diffraction. It was found that the addition of Ti in the Cu-Al-Ni SMAs has increased the transformation temperatures. The results revealed that the addition of Ti led to the formation of a new phase into the microstructure known as X-phase. From the XRD result, it was indicated that the X-phase was AlNi2Ti and Cu3Ti compounds. It was also found that the alloy with 0.7wt% Ti has produced the most effective outcome of the transformation temperature (Ms: 233.16°C, Mf: 225.67°C, As: 229.85°C, Af: 239.25°C) due to the presence of X-phase in the microstructure. Further study will be carried out to investigate the application of this material and focus on the application of the material in damping application.

Background: Girls born with congenital adrenal hyperplasia have virilized external genitalia. There is considerable debate regarding both the outcomes of feminizing genitoplasty and timing of the surgery in this population.Objective: To investigate outcomes of females 46,XX individuals with CAH in Malaysia, the surgical outcomes of feminizing genitoplasty (FG) and their attitudes toward surgery.Study Design: This is a cross-sectional study involving the two main tertiary centers in Malaysia. All 46,XX patients with CAH and raised female, who had undergone FG were identified and invited to participate. Data on socio-demographic, medical profiles, and attitudes toward surgery were collected. A standardized evaluation of the external genitalia was undertaken including the anatomic and cosmetic evaluation by independent gynecologists.Results: Of 61 individuals identified, 59 participated—consisting of children (n = 12), adolescents (n = 29) and adults (n = 18). All but one had classical CAH (98.3%) and had undergone FG (n = 55, 93.2%) with surgery mostly undertaken by pediatric surgeons trained in DSD work (n = 44, 74.6%). Complications overall were low (20.3%), with repeat surgery rate of 9.1%. External genital examination was performed in 38 participants. Overall 36.8% had absent clitoral glands and 39.5% had a persistent urogenital sinus and in 10.5%, no vaginal orifices were seen. Poor cosmetic outcomes were present in 42.1% with 55.3% recommended for further assessment under general anesthetic. Almost half participants did not venture an opinion on FG, those who did varied from having a positive attitude toward it (18 participants) to 3 opining that it should not be done, or avoided or delayed. From the participants, 35.5% preferred FG to be done early in life compared to 44.0% of the parents.Conclusions: The reoperation rates of the feminizing genitoplasty surgeries were low however due to the anatomic and cosmetic outcomes, reassessment of the external genitalia of these CAH patients may be required once they consider becoming sexually active as they may require further treatment. Many factors such as cultural sensitivities and access to medical treatment and late diagnoses have an impact on attitudes toward FG.

PurposeTo evaluate the rate of discordance of epidermal growth factor receptor (EGFR) mutation between primary lung tumor and paired distant metastases in non-small-cell lung cancer (NSCLC).MethodsWe performed a meta-analysis of 17 studies (518 cases) assessing discordance rates of EGFR mutation in primary tumors and paired distant metastases. We performed subgroup analyses based on EGFR mutation status in primary tumor (mutant or wildtype), site of distant metastasis (bone, central nervous system (CNS) or lung/ pleural), methods of testing (direct sequencing or allele-specific testing) and timing of metastasis (synchronous or metachronous).ResultsThe overall discordance rate in EGFR mutation was low at 10.36% (95% CI = 4.23% to 18.79%) and varied widely between studies (I2 = 83.18%). The EGFR discordance rate was statistically significantly higher in bone metastases (45.49%, 95% CI = 14.13 to 79.02) than CNS (17.26%, 95% CI = 7.64 to 29.74; P = 0.002) and lung/ pleural metastases (8.17%, 95% CI = 3.35 to 14.85; P < 0.001). Subgroup analyses did not demonstrate any significant effect modification on the discordance rates by the EGFR mutation status in primary lung tumor, methods of testing and timing of metastasis.ConclusionThe overall discordance rate in EGFR mutation between primary lung tumor and paired distant metastases in NSCLC is low, although higher discordance rates were observed in bone metastases compared with CNS and lung/pleural metastases. Future studies assessing the impact of EGFR mutation discordance on treatment outcomes are required.

The use of radiotherapy, either in the form of stereotactic radiosurgery (SRS) or whole-brain radiotherapy (WBRT), remains the cornerstone for the treatment of brain metastases (BM). As the survival of patients with BM is being prolonged, due to improved systemic therapy (i.e., for better extra-cranial control) and increased use of SRS (i.e., for improved intra-cranial control), patients are clinically manifesting late effects of radiotherapy. One of these late effects is radiation necrosis (RN). Unfortunately, symptomatic RN is notoriously hard to diagnose and manage. The features of RN overlap considerably with tumor recurrence, and misdiagnosing RN as tumor recurrence may lead to deleterious treatment which may cause detrimental effects to the patient. In this review, we will explore the pathophysiology of RN, risk factors for its development, and the strategies to evaluate and manage RN.

Food contamination is a matter of serious concern, as the high concentration of chemicals present in the edibles poses serious health risks. Protecting the public from the degrees of the harmfulness of contaminated foods has become a daunting task. This article highlights the causes, types, and health implications of chemical contamination in food. The food contamination could be due to naturally occurring contaminants in the environment or artificially introduced by the human. The phases of food processing, packaging, transportation, and storage are also significant contributors to food contamination. The implications of these chemical contaminants on human health are grave, ranging from mild gastroenteritis to fatal cases of hepatic, renal, and neurological syndromes. Although, the government regulates such chemicals in the eatables by prescribing minimum limits that are safe for human consumption yet measures still need to be taken to curb food contamination entirely. Therefore, a variety of food needs to be inspected and measured for the presence of chemical contaminants. The preventative measures pertaining about the food contaminants problems are pointed out and discussed.